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| 25 years ago, at about this time of year, while anxious over finishing my Ph.D, I found out that I had cancer and was well into the middle of my six cycles of chemotherapy. The previous entry described the clinical aspects of the treatment. This entry focuses on the personal, ie emotional and mental, aspects as well as the ebb and flow of the 21 day period. There is necessarily some overlap between this entry and the last. |
| What does it feel like to be in the middle of a cancer chemotherapy regimen? In my case the cycle was 21 days. I saw it four stages of roughly 4-5 days each. I will describe each of these four periods in the succeeding paragraphs. |
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Days 1-5 The first period is the worst. After the administration of drugs, and a 6 hour bout with nausea and vomiting, there is a long night's sleep. The first two days after getting the drug, one feels beat up. It is similar to the weakness on feels with the flu. The bodies muscles ache all over and the joints (especially the hips, knees, and ankles) hurt sometimes making it hard to sleep. During this period, it was hard to get around, and all I wanted to do was stay in bed. The next 2 or 3 days are better and the joint pain and achiness subside a little each day. The toxic drugs are a shock to the body, and throughout this experience I learned that the body heals slowly. The damage done by the drugs to normal cells requires the body to reproduce lots of new cells to replace the injured cells. The body must also clear a lot of debris from the cell slaughter. If a large bulk of tumor is destroyed, the flood of waste products can lead to a metabolic problems called tumor lysis syndrome. This condition disrupts the balance of sodium, potassium, calcium or uric acid, and can lead to serious side effects. I did not get this problem. |
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Days 6-12 After the tough few days, the body begins to recover. Throughout the 21 days, the tiredness never goes away. The tiredness (called general malaise) that emanates from the insides is very disheartening. One has trouble focusing, and it is very frustrating to have no stamina. My friends invited me to dinner and outings to movies, museums, or other places, and when I felt well enough, I would go out, but some times I just would rather stay home. Like everything else in life, the effects of chemotherapy led to good days and bad days. I just had a lower baseline than a healthy person. There were usually at least one or two days that were close to normal during this period. |
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Days 13-16 About two weeks after treatments, the blood products that were killed as stem cells on Day 1 were due to enter the blood stream. The was described in detail in the previous installment. The lack of red blood cells causes anemia which increases the tiredness. I only had anemia of any degree one time, and it was not serious enough to require a transfusion or delay treatment. The lack of white blood cells makes one susceptible to infection, and patients must try to avoid any ill people or other sources of infection. I had no problems with infections. the lack of platelets would make it difficult for clotting of blood, so cuts and scrapes are to be avoided. It is also about this time when the hair cells that were killed during treatment falls out. It doesn't fall out all in one go. One day you find a few more hairs than usual on your pillow and in the shower drain. The next day there are more. After three days or so, the hair loss reverses and in a couple of days the hair loss returns to normal. Each treatment killed about 25% of my original hair. |
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Day 17-21 After the second jolt to the system from the blood shortage, the body begins to make a reasonable recovery. One fells best right before the next treatment is due, but one never recovers to 100%, and each round of drugs is a little harder on the system. The time period of the cycle is a careful balance. It must be long enough for the body to recover and get a relatively normal level of each type of blood cells, but it can not be too long either. As my body recoveres, the cancer was also rebuilding. The tumor's rapid growth properties produced many cells to replace those killed by the drugs. Too long a recovery period between treatments would give the cancer a good chance to strengthen and make the chemo treatment less efficient. |
| Throughout the 21 day cycle, I found that I had to force myself to eat. My taste buds were comatose, so food had little taste. My stomach was often queasy, so I had little appetite. I compensated by eating ice cream. I never lost weight as many chemotherapy patients do. I was not very active, and the lack of exercise was not good for the mood. The ups and downs of the treatment takes a mental toll as well. One ends up physically, mentally, and emotionally exhausted. |
| How one responds to a chemotherapy regimen is individual. I responded well in the sense that I had no major health complications. I also had a good prognosis, and was relatively sure that I would have a full recovery after treatment was over. This favorable outlook was a strong motivator that allowed me to understand and tolerate the complications of the medicine. In fact, I was doing so well, that they increased the dose of chemotherapy drugs after the third cycle. There are people who have serious side effects which can cause either delay of termination of the chemotherapy. |
| I have a few more topics to discuss in this series, but I may have not addressed something that you are wondering about. Please help me to speak to topics that may be of interest to others by posting a question or suggesting a topic you think I have not discussed in the comments section. If you would like to remain anonymous, send a question through facebook messaging. If you are wondering it, someone else probably is too. I have made these posts selective to those things that interest me, but I am open to expanding the coverage. Thank you. |
| Stay tuned for more of the story. |
| (Cancer Chronicles is a series of status updates that account the events of 25 years ago when I went through a bout with cancer. Its purposes are multi-fold: catharsis, education, information, celebration, etc. ) |
| This originally was posted to facebook November 17, 2012. |
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